Healthcare Provider Details

I. General information

NPI: 1053684209
Provider Name (Legal Business Name): G & K HEALTH CARE PROFESSIONALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 02/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 ALASKA AVE NW
WASHINGTON DC
20012-1422
US

IV. Provider business mailing address

7700 ALASKA AVE NW
WASHINGTON DC
20012-1422
US

V. Phone/Fax

Practice location:
  • Phone: 301-675-5755
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: HELEN KEMBUMBARA
Title or Position: MANAGER
Credential:
Phone: 301-675-5755